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腹腔镜下膀胱瓣输尿管-膀胱再吻合术治疗良性输尿管狭窄:我们的初步经验。

Laparoscopic ureteroneocystostomy with bladder flap for benign ureteral stenosis: our initial experience.

机构信息

Department of Urology, First Affiliated Hospital of Gannan Medical University, No. 128, Jinling Road, Ganzhou, 341000, Jiangxi, China.

出版信息

Sci Rep. 2024 Jan 23;14(1):2041. doi: 10.1038/s41598-024-52497-3.

Abstract

To present our experience with laparoscopic ureteroneocystostomy with bladder flap (LUCBF) for treating benign ureteral stenosis and evaluate its feasibility and efficacy. The clinical data of 27 patients with benign ureteral stenosis who underwent LUCBF were retrospectively analyzed. After identification and excision of the ureteral stenosis segment, the healthy ureteral stump was dissected and incised longitudinally. A U-shaped or spiral bladder flap was harvested from the anterolateral bladder wall for ureteroplasty. All patients underwent LUCBF successfully, including 14 patients were combined with psoas hitch technique, between 90 and 220 min (median, 155 min). The median length of ureteral defect was 6 cm (range, 5-17 cm). The median blood loss was 40 ml (20-150 ml). The median indwelling time of double-J stent was 8 weeks (range, 4-8 weeks). Five patients (10.6%) suffered postoperative complications during the follow-up period (range, 12-48 months), including fever, hematuria, urinary tract infection and recurrent stenosis. The success rate was 96.3% (26/27). Patients with long ureter defects had longer operative time and more blood loss than short ureter defects. LUCBF was a safe and feasible technique for benign ureteral stenosis. Long ureter defect was related to longer operative time and more blood loss.

摘要

目的

介绍我们应用腹腔镜下膀胱瓣输尿管吻合术(LUCBF)治疗良性输尿管狭窄的经验,并评估其可行性和疗效。

方法

回顾性分析 27 例接受 LUCBF 治疗的良性输尿管狭窄患者的临床资料。在识别和切除狭窄段后,游离并纵向切开健康输尿管残端。从膀胱前外侧壁切取 U 形或螺旋状膀胱瓣进行输尿管成形术。

结果

所有患者均成功完成 LUCBF,其中 14 例联合应用腰大肌悬吊技术,手术时间 90-220min(中位时间 155min)。输尿管缺损长度为 6cm(范围 5-17cm)。术中出血量 40ml(20-150ml)。双 J 支架留置时间 8 周(范围 4-8 周)。27 例患者随访 12-48 个月,5 例(10.6%)术后出现并发症,包括发热、血尿、尿路感染和再狭窄。

结论

LUCBF 是治疗良性输尿管狭窄的一种安全、可行的技术,输尿管长段缺损与手术时间延长和出血量增加有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c8a/10805737/bf3444fb780f/41598_2024_52497_Fig1_HTML.jpg

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